Phonak Terra VS Naida Lumity. Speech Intelligibility

@audio_hunter said:

Is it true that the Terra and Lumity deliver comparable clinical "performance" in this type of environment

The main difference between an entry level aid and a more advanced one is the performance in complex situations. In quiet environments, they should perform similarly.

The Terra is promoted as an entry-level basic hearing aid designed for affordability in developing countries AFAIK. Compared to the Moxi Blu B9 (which is a high-tech level aid), the Terra is a major step down in terms of features. (that she may or not be using).

I’d ask about the price difference between the two, as that could help with the decision. The usual advice is to go for the best aid you can reasonably afford. If they are priced similarly, go with the Naidas.

In the end, the only way to know for sure is to give them a try.

1&3. I had posted the speech audiometry results: the y-axis shows the speech discrimination percentage (wrs), and the x-axis indicates the presentation level in dB at which the words were heard through the headphones.

Here is her audiogram:

2. She is currently using Unitron Moxi Blu B9-R RICs with UP receivers encapsulated in custom earmolds: completely solid on the right and vented on the left. We have started a trial with the Phonak Terra UP BTEs. The custom earmolds, featuring rigid tubing and standard filtered ear hooks, will be ready next week. For now, she is testing the Terra aids with silicone domes, but the performance is terrible. Let's see if things improve once the custom earmolds are fitted.

The Naida Lumity 90 outperforms the Terra in noisy environments due to the noise management features present in this premium version of the Naida. However, this model is more expensive than the Terra.

The Naida Lumity comes in different tech levels: 30, 50, 70, 90, and the 90 is the highest. Moxis also use similar tech levels: 3, 5, 7, and 9. So, the ones you have are the highest Moxi-B tech level. If you want similar features, stay at the same tech level of Naidas.

In other words, it is not just the model but the tech level that you are getting. For example, I would expect the Terra to perform similarly to the Naida Lumity 30. Since we don’t have Terras here, my statement is based on Phonak’s specifications.

You are already trying the Terras, if they don't work then yes, a higher tech level Naida may perform better. BUt as I said before, in quite environments, they should perform similarly.

I've never seen a presentation like that (I'm referring to your original image) but if it's saying she has 80% WR at 90 dB in her left ear and 30% at 90 dB in her right, that would make sense in light of her audiogram. If that's right she's not getting much out of her right ear. It would likely qualify for a cochlear implant. I think she'll notice some improvement with the custom mold in her left ear although she'll still need help from lip reading. (How's her vision?) If she's mainly wanting to hear one on one conversations in quiet, the Terra+ BTEs should do as well as the Lumitys. The Lumity's advantage would be in more complex listening environments. So, my thoughts would be to try the custom molds. If the custom molds (hopefully with Real Ear Measurement to ensure adequate gain) aren't adequate, then I'd suggest a cochlear implant eval. I personally don't think her solution is the Lumity.

Could you please tell me which country you're based in? This would help me interpret the audiogram as the symbols aren't universal. I wouldn't even begin a trial with custom earmolds. The Terra+ product is a very basic product and if you can afford better I'd definitely push for the Naida L UP. Can she handle the battery change herself, or does someone else do it for her?

A cochlear implant would be an interesting option but we have to rule it out because my relative is terrified of that solution

In 2 weeks, I will be taking my relative to the public hospital for an evaluation to compare the benefit provided by the two hearing aids (Unitron RIC UP VS Terra BTE UP) and see which one yields a higher word recognition score on the sound field speech test. I've confirmed that the hospital is equipped with both the "electronic ear" (HIT test box) and REM (Real Ear Measurement) systems. They also have the Matrix test available, although I doubt it will be performed since I only booked an appointment for a hearing aid benefit evaluation. In your opinion, will sound field speech audiometry, combined with REM and HIT box testing, be enough to determine with certainty which of the two hearing aids gives her better speech discrimination?

By the way, an idea just occurred to me. Since the hearing loss in her left ear is well managed by the UP RIC aids, would we get a better overall result in terms of speech discrimination if she wore the Unitron Moxi Blu B9 RIC on the left ear and the Terra UP BTE on the right ear (both with custom earmolds)?

My take: (caveat: I have no training other than a lot of reading on the forum although I do have a medical background in nursing.) IF the WRS of the right ear is really 30% at 90 dB, I don't think any hearing aid is going to do her much good in the right ear, so no I don't think the Unitron in her left and Terra in her right is a good idea.

I've never heard of comparing hearing aids with a soundfield test to see which gives better word recognition. My gut says the tests margin of error is too big to give you a useful result. However I do think it's useful to know if she feels that the Terras are better after they're properly adjusted with REM with custom molds. IF she is a good candidate for cochlear implant, the fear is something that could be worked on.

Thanks for these. Given you Aunt's circumstances I think you should try and get some rechargeable SP BTEs for both ears. These are available from both Signia1 and Resound (devices linked in brand names). It will greatly simplify her care and these devices are also available in different technology levels so you should hopefully be able to find something that suits her budget.

@MDB said:

IF the of the right ear is really 30% at 90 , I don't think any hearing aid is going to do her much good in the right ear,

If you look at the audiogram in question, this would be threshold-level performance and is consistent with the audiogram. Many audiometers cannot present speech at levels higher than this, but that doesn't mean that the individual won't perform better at higher sensation levels. Only that the equipment couldn't get loud enough to prove this. A trial with a more powerful device and unilateral aided testing with the better ear being unaided and masked is required to prove benefit in this case.

@MDB said:

I've never heard of comparing hearing aids with a soundfield test to see which gives better word recognition.

This isn't common with adults, but is common with paediatrics and the same principles apply. It can be very useful for confirming aided benefit.

@audio_hunter said:

it's very unlikely they will have Phonak's fitting software (Phonak Target) installed on their PC. Here is an excerpt from a hospital document:

The AURICAL Otometrics system is compatible and modular with the clinical audiometry, , and otoacoustic emission systems already present in the department running Otosuite software, allowing it to process data on the existing database and share newly acquired tests.

According to the Phonak website, Otosuite is compatible with Phonak Target, but Target itself isn't mentioned in the hospital's document.

They will definitely have Phonak Target available. It's just not something they'd necessarily mention in hospital notes as clinicians don't need to specify that it was used to program Phonak hearing aids because it's a give-in that it was.